title: Subjective social status predicts wintertime febrile acute respiratory illness among women healthcare personnel.
abstract: OBJECTIVE
  We ask whether subjective social status (SSS) predicts rates of wintertime febrile acute respiratory illness (ARI).
  
  
  METHODS
  1,373 women and 346 men were enrolled from September 1 through November 30, 2010 as part of a prospective cohort study of health care personnel (HCP) at two medical centers. A questionnaire was completed at enrollment followed by 20 weeks of surveillance. ARI was an illness with fever and cough self-reported via weekly telephone or Internet-based surveillance.
  
  
  RESULTS
  For both sexes, lower SSS was associated with younger age, less education, lower neighborhood household income, being unmarried, lower occupational status, working in outpatient settings, and poorer self-rated health status. Demographic and occupational covariates explained 23% and 42% of the variance (R²) in SSS among women and men, respectively. Smoking, exercise frequency, and sleep quality were also associated with SSS, but these factors explained little additional variance (3-4%). Among women HCP, lower SSS at enrollment was associated with higher rates of subsequent ARI (unadjusted β = -.21 [±.05], p < .001 for ordinal data). Adjusting for all covariates reduced the effect size of the SSS minimally (adjusted β = -.19 [±.06], p < .001). Among men HCP, there was no univariate SSS-ARI association and after adjusting for all covariates the effect was opposite of our hypothesis (adjusted β = .33 [±.17], p < .05).
  
  
  CONCLUSIONS
  Women (but not men) with lower SSS were more likely to report an ARI during surveillance, and the SSS-ARI association was independent of demographics, occupational status, health, and health behaviors.
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention (CDC).
authors.forename: Mark G
authors.initials: MG
authors.lastname: Thompson
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest.
authors.forename: Allison
authors.initials: A
authors.lastname: Naleway
authors.affiliation: Abt Associates.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ball
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest.
authors.forename: Emily M
authors.initials: EM
authors.lastname: Henkle
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention (CDC).
authors.forename: Leslie Z
authors.initials: LZ
authors.lastname: Sokolow
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention (CDC).
authors.forename: Jennifer
authors.initials: J
authors.lastname: Williams
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention (CDC).
authors.forename: Sue
authors.initials: S
authors.lastname: Reynolds
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention (CDC).
authors.forename: Sarah
authors.initials: S
authors.lastname: Spencer
authors.affiliation: Influenza Division, Centers for Disease Control and Prevention (CDC).
authors.forename: David K
authors.initials: DK
authors.lastname: Shay
authors.affiliation: Abt Associates.
authors.forename: Beth
authors.initials: B
authors.lastname: Brennan
authors.affiliation: Scott & White Healthcare.
authors.forename: Manjusha J
authors.initials: MJ
authors.lastname: Gaglani
mesh_terms: D000208:Acute Disease; D000328:Adult; D059026:Diagnostic Self Evaluation; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis*; D012621:Seasons; D012737:Sex Factors; D012923:Social Class; D011795:Surveys and Questionnaires